Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 07 - HOSPITALS
Chapter 10.07.02 - Nursing Homes
Section 10.07.02.55 - Dietetic Service Area
Universal Citation: MD Code Reg 10.07.02.55
Current through Register Vol. 52, No. 6, March 21, 2025
A. General Requirements. Unless otherwise indicated, all general requirements apply to both new construction and an existing nursing home.
B. Food Service Department.
(1) The size and location of the food service
area shall comply with COMAR 10.15.03.
(2) A catered or satellite system shall be
covered by a contract approved by the Department.
(3) The vendor providing the food shall have
a valid food service permit.
C. Outside Service Entrance. A convenient outside service entrance shall exist to facilitate receiving food supplies and the disposal of waste.
D. Restriction - Entry to Kitchen or Serving Pantry. A toilet room or sleeping room may not open directly into any kitchen or serving pantry.
E. Limitations on Use of Kitchen. The kitchen may not be used as a passageway. It shall be used for no other purpose than activities connected with food service.
F. Janitor Closet or Service Area.
(1) Janitor Closet - New Construction. A
janitor closet or service alcove for the exclusive use of food service areas
shall be provided in, or adjacent to, the dietetic service
department.
(2) The janitor closet
or service alcove shall be:
(a) Equipped with:
(i) A utility sink;
(ii) Storage shelves; and
(iii) A rack for hanging brooms and mops;
and
(b) Connected to
mechanically operated exhaust ventilation.
(3) The plumbing fixture for the utility sink
within a janitor's closet shall be provided with an approved back-flow
prevention device.
G. Space.
(1) There shall be sufficient floor
space in the food service department to permit all activities to function
efficiently without overcrowding or increasing the risk for cross-contamination
of food or equipment from soiled surfaces.
(2) Minimum Space Requirements - New
Construction.
| Homes' LicensedCapacity for Residents | Minimum Space |
| (a) 2 to 10 | 120 square feet. |
| (b) 11 to 35 | 132 square feet plus 12 square feet per licensed bed in excess of 11. |
| (c) 36 to 100 | 430 square feet plus 10 square feet per licensed bed in excess of 36. |
| (d) over 100 | 1,070 square feet plus 8 square feet per licensed bed in excess of 100. |
(3) Space - Existing Nursing Home.
(a) A nursing home that holds full licensure
as of the adoption date of these regulations shall be considered to have an
adequate size dietetic service department.
(b) Renovations of all kitchens shall be
approved by the Department, which will consider modification of the minimum
space requirement based on space available, costs, and type of
service.
(4) Aisle space
between working areas shall be at least 3 feet, and aisle space for main
traffic shall be at least 5 feet wide.
(5) Ceiling height shall be at least 9
feet.
(6) If the licensed capacity
of a nursing home is increased, or if meals are provided to anyone outside of
the nursing home from the food service area of the nursing home, the nursing
home shall provide an additional food service area in accordance with this
chapter. The additional food service area required when meals are provided to
anyone outside of the nursing home is to be calculated by using the total
number of individuals to whom meals are provided.
(7) The kitchen space requirement as
described in this regulation does not apply to occasional special functions
such as picnics or dinners for residents, volunteers, families, or community
groups as long as the nursing home certifies to the Department that providing
meals for a special function will not adversely affect or detract from the
timely provision of meals to the nursing home's residents.
H. Floor Pantries - New Construction.
(1) There shall be at least one food service
floor pantry per nursing care unit.
(2) This area shall be of sufficient size to
accommodate the equipment required for food preparation and service.
(3) The equipment provided in food service
floor pantries shall comply with the requirements of the local health
department.
(4) A food service
floor pantry shall include the following:
(a)
Refrigerator;
(b) Cabinets for dry
storage and supplies;
(c) Work
space;
(d) Sink for purposes other
than hand-washing;
(e) Hand-washing
sink with soap dispenser and disposable paper towel dispenser; and
(f) Except for trays that are assembled in
the main kitchen and then distributed to the nursing care units, equipment to
hold hot food if bulk foods are plated and served to the residents on the
nursing care unit.
(5) A
food service floor pantry shall include the following additional equipment:
(a) Toaster;
(b) Ice-making machine or ice-storage
container;
(c) Work space for tray
preparation;
(d) Equipment to
deliver completed trays;
(e)
Three-compartment sanitizing sink or dishwasher;
(f) Cabinet for dry storage, supplies, and
kitchenware; and
(g) Storage for
trays, tableware, flatware, and utensils.
I. Equipment for Food Preparation and Distributions.
(1) Adequate equipment for
preparation, serving, and distribution of food shall be provided.
(2) A dumbwaiter, elevator, or ramp shall be
provided in a nursing home of more than one story where more than eight
residents above or below the kitchen level receive bedside tray
service.
(3) Equipment to protect
food from dust or contamination and to maintain food at proper temperature
shall be provided to transport food to the residents.
J. Dry Food Storage.
(1) Food Storage Space.
(a) Adequate space shall be provided to store
food supplies.
(b) The amount of
storage space needed to store food depends on the frequency of
deliveries.
(c) It is recommended
that 2 square feet per resident be provided and that the dry food storage area
be located within easy access to the receiving area and the kitchen.
(2) The storeroom shall be cool
and well-ventilated.
(3) All food
supplies shall be stored off the floor and away from the wall to allow for
cleaning.
K. Refrigerated Storage.
(1) Adequate
refrigerated storage, refrigerators, and frozen food storage cabinets shall be
provided and regulated to maintain temperatures prescribed in COMAR
10.15.03.
(2) Food in storage shall
be arranged so that new food items are stored behind old food items.
(3) The oldest foods shall be used first,
known as the first in, first out method.
L. Mobile Food Carts.
(1) All policies and procedures for the
mobile food cart shall be approved by the Department and the nursing home's
local health department before implementation.
(2) Policies and procedures shall address, at
a minimum the following:
(a) Identify how
many staff members will assist with serving food items, pushing the mobile
cart, and delivering meals to the residents;
(b) Ensure proper food protection on three
sides to protect the food;
(c)
Maintain proper temperature control, hot food at a minimum of 135°F and
cold food maintained at a maximum of 41°F;
(d) Record of temperatures before serving
meals on each individual unit;
(e)
Ensure proper food temperatures; and
(f) Hand washing.
(3) The hand washing policy and procedures
referenced in §L(2)(f) of this regulation shall include the following:
(a) Use of a hand sanitizer in lieu of proper
hand washing is not permitted;
(b)
Bare hands may not have direct contact with ready-to-eat food;
(c) Hand washing shall be done before
starting meal service on each individual unit;
(d) When and at what location hand washing
will be done;
(e) Hand washing may
not be done in resident rooms;
(f)
Access to a hand washing sink may not require the opening of a door;
(g) The hand washing sink shall be in a
central, unobstructed location;
(h)
Mobile hand sinks are acceptable as long as a written procedure to meet
sanitation requirements is developed;
(i) The hand sink shall be supplied with hot
and cold water under pressure;
(j)
The unit shall be supplied with adequate waste containers to hold dirty water
until dumping is done; and
(k) The
written procedure shall include the disposal of the dirty water.
Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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